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Amnion Bio or AxoBioMembrane

South Dakota rates for HCPCS Q4211

Amnion Bio or AxoBioMembrane, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does Amnion Bio or AxoBioMembrane cost?

$126

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $170 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$126 to $148
FacilityA hospital or hospital-owned outpatient department$170$126 to $204

How much rates vary

Facilitymedian $170 · 10th to 90th $100 to $245Professionalmedian $126 · 10th to 90th $117 to $182
$100.0$200.0facility $170professional $126

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$125.89
Typical High
$131.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$194.98
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$181.97
Medica
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Midlands
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$204.17
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$263.03

Where South Dakota sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

South Dakota $126 · 25th of 51
MN $148VT $100

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.